三穴五针联合腹部提压法在机械通气患者肺康复中的疗效  

Effect of “three-acupoint and five-needle” therapy combined with abdominal pressure lifting on lung rehabilitation in patients with mechanical ventilation

作　　者：刘晓鹏 柳聪艳 杨宁[1,3] 蔡琛 李晓兵 王红宇 张思森 Liu Xiaopeng;Liu Congyan;Yang Ning;Cai Chen;Li Xiaobing;Wang Hongyu;Zhang Sisen(Department of Emergency,People's Hospital of Henan University of Chinese Medicine/People's Hospital of Zhengzhou,Zhengzhou 450000,China;The Fifth Clinical School of Henan University of Chinese Medicine,Zhengzhou 450000,China;Rehabilitation Medicine Center,People's Hospital of Henan University of Chinese Medicine/People's Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学人民医院/郑州人民医院急诊科,河南郑州450002 [2]河南中医药大学第五临床医学院,河南郑州450002 [3]河南中医药大学人民医院/郑州人民医院康复医学中心,河南郑州450011

出　　处：《中华卫生应急电子杂志》2024年第4期193-198,共6页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：河南省中医药科学研究专项课题(2022ZY1184)。

摘　　要：目的探讨三穴五针联合腹部提压法对机械通气患者肺康复中的疗效评价。方法前瞻性选择2021年7月至2023年2月36 例住院的肺源性有创机械通气的患者作为研究对象,采用随机数字法平均分为对照组与实验组2组:对两组机械通气患者采取一般治疗措施,实验组在常规对照组治疗基础上采用“三穴五针法”联合腹部提压法。比较两组临床疗效、机械通气时间及28 d 生存率。于脱机前比较两组呼吸力学和气道廓清相关指标。比较两组治疗后1、2、3 和7 d 的炎症反应指标。结果实验组机械通气时间显著低于对照组(P<0.05),实验组28 d 病死率低于对照组,但两组之间差异无统计学意义(P>0.05)。实验组脱机前的潮气量和呼气峰值流速(PEF)显著高于对照组(P<0.05),实验组的咳嗽评分(CSS)大于对照组,但两组之间差异无统计学意义(P>0.05)。对照组和实验组治疗后1、2、3 和7 d 时的白介素-6(IL-6)、白介素-10(IL-10)、C-反应蛋白(CRP)和乳酸逐渐降低(P<0.05),实验组治疗后各时间点内IL-6、IL-10、CRP 和乳酸均低于对照组(P<0.05)。结论三穴五针联合腹部提压法在机械通气患者肺康复中可以更好促进患者肺通气功能恢复,缩短机械通气时间,减轻机体炎症反应,但并不能降低患者28 d生存率。Objective To explore the efficacy of“three-acupoint and five-needle”combined with abdominal pressure lifting on lung rehabilitation in patients with mechanical ventilation.Methods Thirtysix hospitalized patients with pulmonary invasive mechanical ventilation from July 2021 to February 2023 were randomly divided into two groups: control group and experimental group. The experimental group was treated with“three-acupoint and five-needle”combined with abdominal pressure lifting on the basis of routine treatment in the control group.The clinical efficacy,mechanical ventilation time and 28-day survival rate were compared between the two groups.The indexes of respiratory mechanics and airway clearance were compared between the two groups before getting off the ventilator. The indexes of inflammatory reaction at 1 day,2 days,3 days and 7 days after treatment were compared between the two groups.Results The time of mechanical ventilation in the experimental group was significantly lower than that in the control group (P<0.05).The 28-day mortality in the experimental group was lower than that in the control group,but there was no significant difference between the two groups (P>0.05). The tidal volume and peak expiratory flow before getting off the ventilator in the experimental group were significantly higher than those in the control group(P<0.05), and the cough strength score in the experimental group was higher than that in the control group,but there was no significant difference between the two groups (P>0.05). The levels of interleukin-6 (IL-6),interleukin-10(IL-10),C-reactive protein (CRP)and lactate decreased gradually in the control group and the experimental group at 1 day, 2 days, 3 days and 7 days after treatment (P<0.05). IL-6, IL-10, CRP and lactate in the experimental group were lower than those in the control group at each time point after treatment(P<0.05).Conclusions The method of“three-acupoint and five-needle”combined with abdominal pressure lifting can better promote the recovery of pulmo

关 键 词：腹部提压法 三穴五针 机械通气 肺康复 

分 类 号：R563[医药卫生—呼吸系统]